<!-- 添加安全管理 -->
<div class="layui-col-md12">
    <div class="layui-col-xs6 layui-col-md12">
        <form class="layui-form form-auto">
            <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
                <legend>基本信息</legend>
            </fieldset>
            <div class="layui-form-item layui-col-md12">
                <div class="layui-inline ">
                    <label class="layui-form-label">车牌号</label>
                    <div class="layui-input-inline">
                        <input type="hidden" class="car_id" name="car_id" value="" />
                        <input type="text" class="layui-input number" name='plate_no' value="" lay-verify="required" data-msg="车牌号不能为空" readonly/>
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">司机</label>
                    <div class="layui-input-inline">
                        <input type="text" name="driver_name" lay-verify="required" autocomplete="off" class="layui-input">
                    </div>
                </div>

            </div>
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">安全类型</label>
                    <div class="layui-input-inline">
                        <select name="" id="" lay-filter="type" class="type" lay-verify="required">
                            <option value="">请选择</option>
                            <option value="1">交通事故</option>
                            <option value="2">交通违规</option>
                        </select>
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">单位/公司</label>
                    <div class="layui-input-inline">
                        <input type="hidden" name="company_id" class="company_id" />
						<input type="text" name="company_name"  class="company_name layui-input"/>
                    </div>
                </div>
            </div>
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">发生地点</label>
                    <div class="layui-input-inline">
                        <input type="text" name="address" lay-verify="required" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">发生时间</label>
                    <div class="layui-input-inline">
                        <input type="text" id="accident_time" name="accident_time" lay-verify="required" autocomplete="off" class="layui-input" readonly>
                    </div>
                </div>
            </div>
            <div class="layui-form-item layui-form-text  layui-col-md12">
                <label class="layui-form-label">描述</label>
                <div class="layui-input-block" style="width:555px;">
                    <textarea placeholder="请输入内容" class="layui-textarea" lay-verify="remark" name='desc'></textarea>
                </div>
            </div>
            <fieldset class="layui-elem-field layui-field-title" style="margin-top: 20px;">
                <legend>处理结果</legend>
            </fieldset>
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">具体情况</label>
                    <div class="layui-input-inline">
                        <input type="text" name="handle_desc" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">处理结果</label>
                    <div class="layui-input-inline">
                        <input type="text" name="handle_result" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
            </div>
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">责任认定</label>
                    <div class="layui-input-inline">
                        <input type="text" name="responsibility" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">定损人</label>
                    <div class="layui-input-inline">
                        <input type="text" name="solve_person" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
            </div>
            <div class="layui-form-item accident" style="display: none"> 
                <div class="layui-inline" >
                    <label class="layui-form-label">保险赔偿金额</label>
                    <div class="layui-input-inline">
                        <input type="text" name="price" lay-verify="number" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">事故备注</label>
                    <div class="layui-input-inline">
                        <input type="text" name="remark" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
            </div>
            <div class="layui-form-item illegal" style="display: none" >
                <div class="layui-inline">
                    <label class="layui-form-label">罚款金额</label>
                    <div class="layui-input-inline">
                        <input type="text" name="amount" lay-verify="number" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">违规备注</label>
                    <div class="layui-input-inline">
                        <input type="text" name="remark" lay-verify="remark" placeholder="" autocomplete="off" class="layui-input">
                    </div>
                </div>
            </div>


            <div class="layui-form-item">
                <label class="layui-form-label">现场照片</label>
                <div class="layui-upload">
                    <div class="layui-upload-list">
                        <img class="layui-upload-img" id="img1" width="100%" height="100%" style="width: 100px;height: 100px;">
                        <p id="demoText"></p>
                        <button type="button" class="layui-btn" style="margin-left: 150px;width: 100px;" id="test1">上传图片</button>
                    </div>
                </div>
            </div>
            <div class="layui-form-item">
                <div class="layui-input-block">
                    <button type="button" style="margin:0 auto;display: inline-block;" class="layui-btn layui-btn-normal keep" lay-submit=""
                        lay-filter="save">保存</button>
                    <button type="button" style="margin:0 auto;display: inline-block;" class="layui-btn layui-btn-normal back">返回上一页</button>
                </div>
            </div>
        </form>
    </div>
</div>